title: Ethnic differences in the cost-effectiveness of targeted and mass screening for high cardiovascular risk in the UK: cross-sectional study.
abstract: OBJECTIVE
  To investigate ethnic differences in the cost-effectiveness of targeted and mass screening for high cardiovascular risk.
  
  
  METHODS
  Simulation of two screening strategies (targeted screening of most deprived areas and mass screening) using cross-sectional data from Health Survey for England.
  
  
  METHODS
  England.
  
  
  METHODS
  9407 adults aged 40-74 years (493 Black Caribbean, 532 Indian, 516 Pakistani/Bangladeshi, 617 Irish and 7249 general population of whom 6633 were White).
  
  
  METHODS
  Coverage of high-risk population, number needed to screen to identify one person at high cardiovascular risk and cost-effectiveness of targeted screening, with incremental analysis of expanding targeted to mass screening.
  
  
  RESULTS
  Coverage, number needed to screen and cost-effectiveness of targeted screening were better in all ethnic minority groups compared with the White group and general population. Targeted screening would identify 19.2% of high-risk individuals in the general population, and require 4.1 people to be screened to identify one person at high cardiovascular risk at a cost of £98. In the Pakistani/Bangladeshi group, 68.7% of the high-risk population would be identified, and only 2.5 people would need to be screened at a lower cost of £59. In comparison with targeted screening, mass screening was less cost-effective overall but the cost per additional high-risk individual detected was the lowest among the South Asian groups (Indian £130 and Pakistani/Bangladeshi £94).
  
  
  CONCLUSIONS
  Irrespective of whether cardiovascular screening is targeted or universal, it is more cost-effective in South Asian ethnic groups than in the general population. Therefore, cardiovascular screening has the potential to reduce ethnic health inequalities.
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, , Glasgow, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Baker
authors.forename: Richard
authors.initials: R
authors.lastname: Mitchell
authors.forename: Kenny
authors.initials: K
authors.lastname: Lawson
authors.forename: Jill
authors.initials: J
authors.lastname: Pell
mesh_terms: D000328:Adult; D000368:Aged; D001211:Asia, Western / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000191:economics / Q000208:ethnology*; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods; D008875:Middle Aged; D044469:Racial Groups / Q000208:ethnology*; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology